Detection of nodal metastases in men with pelvic urogenital malignancies is important for accurate staging and has therapeutic and prognostic implications. Knowledge of clinical anatomy of these nodes and the lymphatic pathways is critical for assigning the correct N or M staging and to assess the treatment response. Both computed tomography and magnetic resonance imaging use size and morphologic criteria for nodal characterization. The limitations of these criteria have formed basis newer functional imaging tools. This article focuses on the clinical anatomy, pathways of lymphatic spread of malignancies, current criteria, and newer advances in imaging of male pelvic nodes.
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